Girl S, who received LASIK surgery 10 years ago, had to wear glasses or contacts again as her vision became worse over time. She visited the clinic where she had the surgery and requested re-surgery out of discomfort and concern about decreased vision, but the clinic said she could not receive a reoperation since it had been a long time since she received LASIK.

Since the 1990s when LASIK was introduced for the first time in Korea, it is estimated that more than 100,000 people have received vision correction surgery.

With advances in medical technology, side effects have reduced and stability has increased compared to the early days of LASIK. However, when people receive the surgery when technology was not at the level of where it is today, there have been cases with side effects, night glare, and decreased vision.

Like Girl S, there are many people who want to have re-surgery as their vision has deteriorated since receiving vision correction surgery. They decide to have reoperation from just a few months to 10 years after surgery.

The cause for myopic degeneration can be found in changes in the cornea. As the cornea tends to return to its previous condition, myopia may occur again after surgery. This occurs more in high myopia. The removed cornea thickens again, which results in myopia.

Myopic degeneration may occur within a few months to one year or 2-5 years after surgery. In addition to decreased vision like myopic degeneration, the number of people who have re-surgery due to night glare, eye dry syndrome, corneal opacity, and keratoconus, which may occur after LASIK/LASEK, is also growing.

According to the report Long-term Stability and Safety of Myopia Correction Surgery published by the National Evidence-based Healthcare Collaborating Agency in 2011 on patients who received myopia correction surgery including LASIK, myopic degeneration in which optical power decreases by more than 10% between 1 to 3 years after surgery compared to 3 months after surgery occurs at 4.5% in LASIK and 8% in LASEK.

Like Girl S, there are many myopic degeneration patients wearing glasses who are able to undergo re-surgery after their initial clinic said they could not get it. In fact, LASIK/LASEK re-surgery is not necessarily easier than the first surgery, so many physicians are hesitant to perform it. However, re-surgery may be considered positively if you are wearing glasses and your vision is corrected even though your vision has deteriorated.

To begin with, it is important to accurately assess the cause of vision deterioration after surgery. This is because the cause for deteriorated vision after surgery can be due to dry eye syndrome and cataracts in addition to myopic degeneration.

Myopic degeneration, which occurs relatively shortly after surgery, is caused by regeneration and remodeling in the cornea right after surgery in most cases. In other words, myopic degeneration occurs as regeneration takes place in the site cut open by a laser in the middle of the cornea and thatarea gets thicker, or a flattened cornea tends to return to its curved condition.

Meanwhile, vision having decreased over quite a long time is mostly attributable to aging, eye/vision habits, or diseases like cataracts, retinal disorder, and dry eye syndrome.

Depending on the cause, a treatment method or the possibility of re-surgery may differ. As some people whose vision decreases after vision correction surgery have some other reason for their poor vision such as dry eye syndrome and cataracts, it is important to examine exactly why your vision has deteriorated.

If you decided to have re-surgery, what needs to be considered first and foremost is ‘residual cornea’ left after the first surgery. If your cornea is thick enough, you can restore your vision with re-surgery regardless of whether you have LASIK, LASEK, or intraocular lens implantation. To make sure that enough of the cornea is left even after re-surgery, it is essential to accurately predict before the surgery and perform the surgery in the most delicate way.

Anterior chamber CT scanning, which can examine how thick the cornea is, and Pentacam examination, which can look at both the surface and behind the cornea, need to be taken. It is because side effects such as keratoconus, where the cornea stretches as it thins and weakens thus applying pressure to the eye, or delayed corneal opacity, where a scar (corneal opacity) occurs on the surgical site 6 months to 1 year postoperatively, may occur.

For re-surgery patients, it would be better to perform corneal cross-linking together, which increases the stability of LASEK and LASIK and strengthens the tissue of the cornea. If there is not enough cornea remaining, it might be possible to plan re-surgery with intraocular lens implantation.

If LASIK/LASEK re-surgery is performed in the same way as the first one, myopia is more likely to occur again than the first time even if the vision is corrected. Side effects such as night glare or dry eye syndrome may also increase. Hence, a larger area needs to be removed than the initial surgery.

Caution is needed as LASIK/LASEK re-surgery requires a different level of skill and sophistication than the first surgery. This is because LASIK re-surgery does not actually create a new flap but lifts the previously created flap again.

It is important to use a technique which keeps corneal epithelial cells from getting below the flap and accurately positions and places the flap in its original position. If corneal epithelial cells move below the flap (corneal epithelial ingrowth), it may cause corneal opacity, and another surgery is needed to eliminate it.

While it is better to perform LASIK re-surgery with LASIK and LASEK re-surgery with LASEK, it has recently been reported that LASEK re-surgery after LASIK exhibited stable results. Thus, if the LASIK flap or the cornea is thin, LASEK is performed.

It is often the case that those who received LASEK first have a thin cornea, and it is not possible to perform LASIK. So, re-surgery is also performed with LASEK for such individuals. For LASEK re-surgery, the procedure that adjusts M LASEK, which prevents corneal opacity, should be used at this clinic.

Likewise, there is a growing number of patients who want LASIK/LASEK re-surgery after they received their first vision correction surgery and their vision deteriorated. This clinic opened a LASIK/LASEK re-surgery center for the first time in Korea and has recorded remarkable achievements.

These achievements are possible thanks to cutting-edge equipment, which not only accurately diagnoses the condition of the cornea before re-surgery but also precisely predicts vision and the condition of the cornea after re-surgery, and as well as the aptitude of our specialists.

To reduce post-operative regression, it is important to avoid excessive drinking or smoking after surgery. Delicate care might help your corrected vision to last longer, including blinking often to keep the tear film moisturized and ensuring enough rest for your eyes when you use your smartphone or PC for a long time.